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General NPI Number Information
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NPI Number | 1194744227
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Entity Type | Organization
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Legal Business Name | ALCOHOL & DRUG COUNCIL OF TOMPKINS COUNTY, INC.
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Dates
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Enumeration Date | 07/19/2006
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Last Update Date | 03/25/2015
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Provider Practice Location Address
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Address Line | 201 E GREEN ST STE 500
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City | ITHACA
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State | NY
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Zip | 14850-5635
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Country | US
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Telephone | 607-274-6288
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Fax | 607-274-6280
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Provider Business Mailing Address
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Address Line | 201 E GREEN ST STE 500
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City | ITHACA
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State | NY
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Zip | 14850-5635
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Country | US
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Telephone | 607-274-6288
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Fax | 607-274-6280
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Authorized Official
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Title or Position | DIRECTOR OF FINANCE & ADMINISTRATIO
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Name | LYNNE TEETER
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Credential |
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Telephone | 607-274-6288
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QR0405X
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Taxonomy Name | Substance Use Disorder Rehabilitation Clinic/Center
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License Number | 070410653
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License Number State | NY
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